BIO JUKU application form

    Name *
    Gender *
    Birthday *
    Day Month Year
    Age (As of February 17, 2022)
    Postcode *
    Address *
    Contact telephone number *
    Email address (this must not be a mobile email address)*
    Confirm email address *
    Current university,college,or school *
    Department *
    Academic year *
    Which laboratories are you interested in? *
    1st choice:
    2nd choice:
    3rd choice:
    4th choice:
    5th choice:
    How did you know about BIO JUKU? *
    Homepage,SNSRecommendationWeb searchOther
    Additional note (e.g. Questions)